NeuroMuscular Therapy Massage: Pain Pain Go Away

What Is NMT?

The term “Neuromuscular Therapy Massage” has been around for some time, and many looking for relief from pain are familiar with it. But often, people are unclear about what it really means. This post is an attempt at a brief, if less than comprehensive, description of the history, reasoning behind the techniques, and the how and why of what I do regularly in my practice.

Neuromuscular therapy massage is an approach that manipulates the soft tissue (muscle, tendon, ligament, connective tissue) to support balance between the musculoskeletal and central nervous systems. The goal is to help relieve pain and dysfunction by understanding and alleviating the underlying cause, thereby reestablishing equilibrium.

First, A Little History

NMT was born in the 1930’s and 40’s in England by two cousins, both of whom were chiropractors and naturopaths. Stanley Lief and Boris Chaitow developed a program of assessment and treatment of soft tissue dysfunction, calling it European style neuromuscular techniques (NMT European).

Soon after its inception, the ideas began making their way over to the United States. Raymond Nimmo and James Vannerson began publishing a newsletter in the US, providing the first research results into what are commonly known today as trigger points (hyperirritablespots inskeletal muscle, associated with palpablenodulesintautbands ofmuscle fibers).[1] Research continued, and the concepts kept bearing out positive results.

In 1983 and 1992, the two volumes of “Myofascial Pain and Dysfunction; The Trigger Point Manual”; Travell and Simons, were published. The latest editions of these books have become must-haves for serious practitioners using these techniques.

Paul St. John, a student of Raymond Nimmo, developed his own system of NMT in the US in the late 1970’s, based on the European system. Judy DeLaney joined him in the mid-eighties, and the two of them brought these techniques into the massage setting. Eventually, Judy DeLaney branched out to develop her own approach, calling it NMT American.

In the early 2000’s, Delaney and Leon Chaitow published “Clinical Applications of Neuromuscular Techniques Volumes 1 and 2”, integrating NMT European and American Versions, along with many other assessment and soft tissue techniques.[2]

To this day, research continues to better understand the hows and whys of many pain syndromes associated with soft tissue and trigger points. New appreciation of connective tissue as an important system of information and movement in the body is leading us to think differently, and much more holistically, about how we tick.

What Exactly IS a Trigger Point?

While the definition has always been a work in progress, the generally accepted understanding is that it is a small segment of muscular or fascial tissue that has become irritated, and forms a nodule or tight band in the tissue. On stimulation, a more or less predictable pattern of pain can be produced. A trigger point can refer pain to remote parts of the body, and can actually activate secondary trigger points.

How Do Trigger Points Develop, Anyway?

There are many reasons trigger points can develop. Posture (how we hold ourselves while moving through our lives), is a common cause, affected by our movements, our psychology and pretty much all other aspects of our lives. How we use/ misuse/ overuse our bodies; our level of physical activity; how much stress is in our lives; whether we get enough quality sleep; the food we eat; the environment we live in; all can be causes.

There are 5 pain-producing conditions that are commonly addressed with NMT

1) Ischemia

When an area of tissue has been stressed for extended periods of time, the tissue mats down, causing restriction of the blood supply, reducing access to adequate oxygen and other nutrients necessary for the health of the tissue

Deviations of the body from a mechanical “norm”, typically the result of gravity’s pull and routine activities (working at a computer, driving, slumping while seated), which hold the body in an imbalanced position, and which eventually become locked in the tissue

5) Biomechanical Dysfunction

Imbalance in the musculoskeletal system resulting from faulty movement patterns. These are often brought on by injury, often seemingly insignificant, and in many cases have not been properly identified and addressed.

What Techniques Are Commonly Used In NMT?

There are a vast number of techniques available to release trigger points and increase mobility. When I apply these techniques, I blend then with more calming approaches, like Myofascial Release, Cranial Sacral and general massage. These tend to counteract the sometimes more stimulating effects of therapeutic work. Specific NMT tools I use for deeper, more therapeutic work include:

1) Static compression

Finding the area of tissue that is the most constricted, and the most sensitive

Applying pressure and holding for a period of time until the tissue releases

I often use passive and active movement of the area being addressed during these holds

2) Skin rolling

Lifting skin away from the underlying structure, rolling it between the fingers, and moving through the tissue

3) Effleurage

Standard massage technique, gliding in the direction of the tissue being addressed

4) Cross fiber fractioning

At the area being addressed, moving across the direction of the tissue

5) Stretching and movement techniques to lengthen the tissue after release

My hope is that a clear understanding of NMT will encourage people who have never heard of it, or have heard of it but didn’t really understand it, to be more comfortable with the idea that bodywork can be a means of attaining better mobility, less discomfort and better overall physical health.